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NPI Code Detail

MEDICARE: TOBY HOUSE, INC.

MEDICARE: TOBY HOUSE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorBH-2792AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1600068100OTHERAZMAGELLAN

General Provider Information

NPI Number : 1356514087
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOBY HOUSE, INC.
Provider Business Mailing Address
First Line : 5717 N 7TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-5802
Country : US
Telephone Number : 602-234-3338
Fax Number :
Provider Business Practice Location Address
First Line : 5717 N 7TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-5802
Country : US
Telephone Number : 602-234-3338
Fax Number :
Authorized Official
Title or Position : COMPTROLLER
Name : CHARLES CAWLEY
Credential :
Telephone Number : 602-234-3338
Provider Enumeration Date : 04/02/2008
Last Update Date : 04/02/2008

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